Domain transformation learning for MR image reconstruction from dual domain input.

Medical images are acquired through diverse imaging systems, with each system employing specific image reconstruction techniques to transform sensor data into images. In MRI, sensor data (i.e., k-space data) is encoded in the frequency domain, and fully sampled k-space data is transformed into an image using the inverse Fourier Transform. However, in efforts to reduce acquisition time, k-space is often subsampled, necessitating a sophisticated image reconstruction method beyond a simple transform. The proposed approach addresses this challenge by training a model to learn domain transform, generating the final image directly from undersampled k-space input. Significantly, to improve the stability of reconstruction from randomly subsampled k-space data, folded images are incorporated as supplementary inputs in the dual-input ETER-net. Moreover, modifications are made to the formation of inputs for the bi-RNN stages to accommodate non-fixed k-space trajectories. Experimental validation, encompassing both regular and irregular sampling trajectories, validates the method's effectiveness. The results demonstrated superior performance, measured by PSNR, SSIM, and VIF, across acceleration factors of 4 and 8. In summary, the dual-input ETER-net emerges as an effective both regular and irregular sampling trajectories, and accommodating diverse acceleration factors.

Influence of laminectomy on the lumbosacral cerebrospinal fluid volume: A retrospective magnetic resonance imaging study.

The cerebrospinal fluid volume affects the block height of spinal anaesthesia. Laminectomy of the lumbar spine may result in increased lumbosacral cerebrospinal fluid volume. This study aimed to test the hypothesis that the lumbosacral cerebrospinal fluid volume of patients with a history of lumbar laminectomy would be larger than that of patients with normal lumbar spine anatomy using magnetic resonance imaging. Lumbosacral spine magnetic resonance images of 147 patients who underwent laminectomy at the L2 vertebrae or below (laminectomy group) and 115 patients without a history of spinal surgery (control group) were retrospectively reviewed. The lumbosacral cerebrospinal fluid volumes between the L1-L2 intervertebral disc level and the end of the dural sac were measured and compared between the two groups. The mean (standard deviation) lumbosacral cerebrospinal fluid volume was 22.3 (7.8) ml and 21.1 (7.4) ml in the laminectomy and control groups, respectively (mean difference 1.2 ml; 95% confidence interval -0.7 to 3.0 ml; P = 0.218). In the prespecified subgroup analysis according to the number of laminectomy levels, patients who underwent more than two levels of laminectomy exhibited slightly larger lumbosacral cerebrospinal fluid volume (n = 17, 30.5 (13.5) ml) compared with those who underwent two (n = 40, 20.7 (5.6) ml; P = 0.014) or one level of laminectomy (n = 90, 21.4 (6.2) ml; P = 0.010) and the control group (21.1 (7.4) ml; P = 0.012). In conclusion, the lumbosacral cerebrospinal fluid volume did not differ between patients who underwent lumbar laminectomy and those without a history of laminectomy. However, patients who underwent laminectomy at more than two levels had a slightly larger volume of lumbosacral cerebrospinal fluid than those who underwent less extensive laminectomy and those without a history of lumbar spine surgery. Further studies are warranted to confirm the subgroup analysis findings and elucidate the clinical implications of such differences in the lumbosacral cerebrospinal fluid volume.

Sodium intake trend and current intake level by meal provision place among the citizens of Seoul.

BACKGROUND/OBJECTIVES: The diversity of meal provision places has increased in recent years and sodium intake can vary depending on where meals are eaten, particularly in large cities. In this study, an analysis of the recent trends in sodium intake was performed and a comparison of sodium intake level according to meal provision place among citizens of Seoul was performed. SUBJECTS/METHODS: Data from a 24-h recall dietary intake survey from the 2010-2019 Korea National Health and Nutrition Examination Survey (KNHANES) were used in order to determine the trends in sodium intake among citizens of Seoul, aged 3-74 years old. (n = 11,811). The trend of daily sodium intake was presented in absolute amount and proportion compared to the chronic disease risk reduction intake (CDRR) for each selected characteristic. A comparison of sodium intake level according to meal provision place by sex and age groups as a total amount per meal (mg), density per meal (mg/1,000 kcal), and proportion of the daily sodium intake was performed using the 2016-2019 KNHANES. RESULTS: Sodium intake levels showed a downward trend from 2010-2019. The highest level of sodium intake was observed for subjects aged 30-49, and the level for males aged 30-49 was 202.8% higher than the CDRR. Results of the analysis of sodium intake per meal according to meal provision place showed that the highest sodium intake was in the order of restaurant meal (RM) > institutional foodservice (IF) > home meal (HM) > convenience food (CF). A higher sodium density (mg/1,000 kcal) was observed for IF compared with RM in most adults. Adults aged over 50 years old consumed more than half of the daily sodium in HM. CONCLUSION: Significant variation in the level of sodium intake was observed according to sex and age groups, therefore, different approaches and nutrition policies based on meal provision place are needed.

Association between the Dietary Phytochemical Index and Lower Prevalence of Obesity in Korean Preschoolers.

Little is known regarding Korean preschooler dietary phytochemical index (DPIs). We used the 24 h recall data of 1196 participants aged 3-5 years from the Korea National Health and Nutrition Examination Survey to study the association between dietary food intake and obesity prevalence. The amount of dietary intake by food group was compared according to sex and DPI quartile. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression models. The average total DPI and energy from phytochemical food groups were not significantly different according to sex, although boys had a higher total daily food intake. Different inclinations between DPI quartiles and amount of intake were observed in the food groups; specifically, beans showed a higher intake difference between Q1 and Q4 for boys than in the other food groups. The highest DPI quartile had a significantly lower obesity prevalence than the lowest DPI quartile in all models for boys only when obesity prevalence by weight percentile was analyzed (Model 3, OR: 0.287, 95% CI: 0.095-0.868, p for trend < 0.05). Our results suggest a high DPI could help prevent obesity in preschoolers.

A Shape Memory Alloy-Based Soft Actuator Mimicking an Elephant's Trunk.

Soft actuators that execute diverse motions have recently been proposed to improve the usability of soft robots. Nature-inspired actuators, in particular, are emerging as a means of accomplishing efficient motions based on the flexibility of natural creatures. In this research, we present an actuator capable of executing multi-degree-of-freedom motions that mimics the movement of an elephant's trunk. Shape memory alloys (SMAs) that actively react to external stimuli were integrated into actuators constructed of soft polymers to imitate the flexible body and muscles of an elephant's trunk. The amount of electrical current provided to each SMA was adjusted for each channel to achieve the curving motion of the elephant's trunk, and the deformation characteristics were observed by varying the quantity of current supplied to each SMA. It was feasible to stably lift and lower a cup filled with water by using the operation of wrapping and lifting objects, as well as effectively performing the lifting task of surrounding household items of varying weights and forms. The designed actuator is a soft gripper that incorporates a flexible polymer and an SMA to imitate the flexible and efficient gripping action of an elephant trunk, and its fundamental technology is expected to be used as a safety-enhancing gripper that requires environmental adaptation.

Shape Memory Alloys in Textile Platform: Smart Textile-Composite Actuator and Its Application to Soft Grippers.

In recent years, many researchers have aimed to construct robotic soft grippers that can handle fragile or unusually shaped objects without causing damage. This study proposes a smart textile-composite actuator and its application to a soft robotic gripper. An active fiber and an inactive fiber are combined together using knitting techniques to manufacture a textile actuator. The active fiber is a shape memory alloy (SMA) that is wire-wrapped with conventional fibers, and the inactive fiber is a knitting yarn. A knitted textile structure is flexible, with an excellent structure retention ability and high compliance, which is suitable for developing soft grippers. A driving source of the actuator is the SMA wire, which deforms under heating due to the shape memory effect. Through experiments, the course-to-wale ratio, the number of bundling SMA wires, and the driving current value needed to achieve the maximum deformation of the actuator were investigated. Three actuators were stitched together to make up each finger of the gripper, and layer placement research was completed to find the fingers' suitable bending angle for object grasping. Finally, the gripping performance was evaluated through a test of grasping various object shapes, which demonstrated that the gripper could successfully lift flat/spherical/uniquely shaped objects.

An End-to-End Recurrent Neural Network for Radial MR Image Reconstruction.

Recent advances in deep learning have contributed greatly to the field of parallel MR imaging, where a reduced amount of k-space data are acquired to accelerate imaging time. In our previous work, we have proposed a deep learning method to reconstruct MR images directly from k-space data acquired with Cartesian trajectories. However, MRI utilizes various non-Cartesian trajectories, such as radial trajectories, with various numbers of multi-channel RF coils according to the purpose of an MRI scan. Thus, it is important for a reconstruction network to efficiently unfold aliasing artifacts due to undersampling and to combine multi-channel k-space data into single-channel data. In this work, a neural network named 'ETER-net' is utilized to reconstruct an MR image directly from k-space data acquired with Cartesian and non-Cartesian trajectories and multi-channel RF coils. In the proposed image reconstruction network, the domain transform network converts k-space data into a rough image, which is then refined in the following network to reconstruct a final image. We also analyze loss functions including adversarial and perceptual losses to improve the network performance. For experiments, we acquired k-space data at a 3T MRI scanner with Cartesian and radial trajectories to show the learning mechanism of the direct mapping relationship between the k-space and the corresponding image by the proposed network and to demonstrate the practical applications. According to our experiments, the proposed method showed satisfactory performance in reconstructing images from undersampled single- or multi-channel k-space data with reduced image artifacts. In conclusion, the proposed method is a deep-learning-based MR reconstruction network, which can be used as a unified solution for parallel MRI, where k-space data are acquired with various scanning trajectories.

Reconstruction for plane-wave ultrasound imaging using modified U-Net-based beamformer.

An image reconstruction method that can simultaneously provide high image quality and frame rate is necessary for diagnosis on cardiovascular imaging but is challenging for plane-wave ultrasound imaging. To overcome this challenge, an end-to-end ultrasound image reconstruction method is proposed for reconstructing a high-resolution B-mode image from radio frequency (RF) data. A modified U-Net architecture that adopts EfficientNet-B5 and U-Net as the encoder and decoder parts, respectively, is proposed as a deep learning beamformer. The training data comprise pairs of pre-beamformed RF data generated from random scatterers with random amplitudes and corresponding high-resolution target data generated from coherent plane-wave compounding (CPWC). To evaluate the performance of the proposed beamforming model, simulation and experimental data are used for various beamformers, such as delay-and-sum (DAS), CPWC, and other deep learning beamformers, including U-Net and EfficientNet-B0. Compared with single plane-wave imaging with DAS, the proposed beamforming model reduces the lateral full width at half maximum by 35% for simulation and 29.6% for experimental data and improves the contrast-to-noise ratio and peak signal-to-noise ratio, respectively, by 6.3 and 9.97 dB for simulation, 2.38 and 3.01 dB for experimental data, and 3.18 and 1.03 dB for in vivo data. Furthermore, the computational complexity of the proposed beamforming model is four times less than that of the U-Net beamformer. The study results demonstrate that the proposed ultrasound image reconstruction method employing a deep learning beamformer, trained by the RF data from scatterers, can reconstruct a high-resolution image with a high frame rate for single plane-wave ultrasound imaging.

A Comparative Study of Birdcage RF Coil Configurations for Ultra-High Field Magnetic Resonance Imaging.

Improvements in transmission and reception sensitivities of radiofrequency (RF) coils used in ultra-high field (UHF) magnetic resonance imaging (MRI) are needed to reduce specific absorption rates (SAR) and RF power deposition, albeit without applying high-power RF. Here, we propose a method to simultaneously improve transmission efficiency and reception sensitivity of a band-pass birdcage RF coil (BP-BC RF coil) by combining a multi-channel wireless RF element (MCWE) with a high permittivity material (HPM) in a 7.0 T MRI. Electromagnetic field (EM-field) simulations, performed using two types of phantoms, viz., a cylindrical phantom filled with oil and a human head model, were used to compare the effects of MCWE and HPM on BP-BC RF coils. EM-fields were calculated using the finite difference time-domain (FDTD) method and analyzed using Matlab software. Next, to improve RF transmission efficiency, we compared two HPM structures, namely, a hollow cylinder shape HPM (hcHPM) and segmented cylinder shape HPM (scHPM). The scHPM and MCWE model comprised 16 elements (16-rad BP-BC RF coil) and this coil configuration demonstrated superior RF transmission efficiency and reception sensitivity along with an acceptable SAR. We expect wider clinical application of this combination in 7.0 T MRIs, which were recently approved by the United States Food and Drug Administration.

Surface Engineering of Palladium Nanocrystals: Decoupling the Activity of Different Surface Sites on Nanocrystal Catalysts.

The existence of various surface active sites within a nanocrystal (NC) catalyst complicates understanding their respective catalytic properties and designing an optimal catalyst structure for a desired catalytic reaction. Here, we developed a novel approach that allows unequivocal investigation on the intrinsic catalytic reactivity of the edge and terrace atoms of NCs. Through the comparison of the catalytic behaviors of edge-covered Pd NCs, which were prepared by the selective deposition of catalytically inactive Au atoms onto the edge sites of rhombic dodecahedral (RD) Pd NCs, with those of the pristine RD Pd NCs toward alkyne hydrogenation and Suzuki-Miyaura coupling reactions, we could decouple the activity of the edge and {110}-plane atoms of the Pd NCs without uncertainties. We expect that this study will provide an opportunity to scrutinize the surface properties of various NC catalysts to a more precise level and devise ideal catalysts for intended catalytic reactions.

A 2D-GRAPPA Algorithm with a Boomerang Kernel for 3D MRI Data Accelerated along Two Phase-Encoding Directions.

For the reconstruction of 3D MRI data that are accelerated along the two phase-encoding directions, the 2D-generalized autocalibrating partially parallel acquisitions (GRAPPA) algorithm can be used to estimate the missing data in the k-space. We propose a new boomerang-shaped kernel based on theoretic and systemic analyses of the shape and dimensions of the kernel. The reconstruction efficiency of the 2D-GRAPPA algorithm with the proposed boomerang-shaped kernel (i.e., boomerang kernel (BK)-2D-GRAPPA) was compared with other 2D-GRAPPA algorithms that utilize different types of kernels (i.e., EX-2D-GRAPPA and SK-2D-GRAPPA) based on computer simulation, phantom and in vivo experiments. The proposed method was validated for different sets of ACS lines with acceleration factors from four to eight and various sizes of the kernels. A quantitative analysis was also performed by comparing the normalized root mean squared error (nRMSE) in the images and the undersampled edges. Computer simulation, in vivo and phantom experiments, and the quantitative analysis, showed that the proposed method could reduce aliasing artifacts without reducing the SNRs of the reconstructed images.

A brain extraction algorithm for infant T2 weighted magnetic resonance images based on fuzzy c-means thresholding.

It is challenging to extract the brain region from T2-weighted magnetic resonance infant brain images because conventional brain segmentation algorithms are generally optimized for adult brain images, which have different spatial resolution, dynamic changes of imaging intensity, brain size and shape from infant brain images. In this study, we propose a brain extraction algorithm for infant T2-weighted images. The proposed method utilizes histogram partitioning to separate brain regions from the background image. Then, fuzzy c-means thresholding is performed to obtain a rough brain mask for each image slice, followed by refinement steps. For slices that contain eye regions, an additional eye removal algorithm is proposed to eliminate eyes from the brain mask. By using the proposed method, accurate masks for infant T2-weighted brain images can be generated. For validation, we applied the proposed algorithm and conventional methods to T2 infant images (0-24 months of age) acquired with 2D and 3D sequences at 3T MRI. The Dice coefficients and Precision scores, which were calculated as quantitative measures, showed the highest values for the proposed method as follows: For images acquired with a 2D imaging sequence, the average Dice coefficients were 0.9650 ± 0.006 for the proposed method, 0.9262 ± 0.006 for iBEAT, and 0.9490 ± 0.006 for BET. For the data acquired with a 3D imaging sequence, the average Dice coefficient was 0.9746 ± 0.008 for the proposed method, 0.9448 ± 0.004 for iBEAT, and 0.9622 ± 0.01 for BET. The average Precision was 0.9638 ± 0.009 and 0.9565 ± 0.016 for the proposed method, 0.8981 ± 0.01 and 0.8968 ± 0.008 for iBEAT, and 0.9346 ± 0.014 and 0.9282 ± 0.019 for BET for images acquired with 2D and 3D imaging sequences, respectively, demonstrating that the proposed method could be efficiently used for brain extraction in T2-weighted infant images.

Sustainable Surface-Enhanced Raman Substrate with Hexagonal Boron Nitride Dielectric Spacer for Preventing Electric Field Cancellation at Au-Au Nanogap.

Nanogaps between Au nanoparticles and Au substrates are the simplest systems that generate extremely high electric fields at hotspots for surface-enhanced Raman spectroscopy (SERS). However, the electric field cancellation at the hotspots in the systems can cause the reduction of Raman signal when two metallic materials are physically contacted due to the low concentration of analytes. Here, we propose an atomically thin hexagonal boron nitride (h-BN) shielding layer for Au substrates, which can be used as an insulating spacer to prevent electrical shorts at nanogaps. Experimental investigation of the SERS effect combined with theoretical studies by finite-difference time-domain simulations demonstrate that the Au NP/h-BN/Au substrate structure has excellent performance in electrical short prevention, thus facilitating ultrasensitive Raman detection. The outstanding chemical and thermal stability of h-BN allow the efficient recycling of the SERS substrate by protecting the Au surface during the removal of Au NPs and molecular analytes by chemical and thermal processes.

Association between Diet Quality and Sarcopenia in Older Adults: Systematic Review of Prospective Cohort Studies.

(1) Background: Nutrition is a key determinant of sarcopenia in later life. (2) Methods: A systematic review of prospective cohort studies examining association of diet quality with muscle mass (MM), muscle strength (MS) or physical performance (PP) among older adults was conducted. A total of 22,885 results were obtained from a literature search in MEDLINE via PubMed and EMBASE up to November 2020. Inclusion criteria included diet quality assessment via dietary indices or statistical approaches, a sample of adults aged 45 years and over at baseline in a longitudinal study design. (3) Results: Of the 22,885 cohort studies, 14 studies were eligible. Meaningful results were obtained for the Mediterranean diet and Nordic diet regarding the decrease of sarcopenia risk, however results from non-European countries were inconsistent. In addition, due to the insufficient number of studies on Japanese Food Guide Spinning Top (JFG-ST), dietary variety score (DVS), and dietary quality index-international (DQI-I), effectiveness was difficult to prove. Studies using factor analysis to examine dietary patterns suggested that the risk of sarcopenia is increased with a high in saturated fat diet such as westernized pattern etc. (4) Conclusion: In this systematic review it was found that various diet qualities are meaningful to a decreased risk of sarcopenia.

Decoration of CuO NWs Gas Sensor with ZnO NPs for Improving NO2 Sensing Characteristics.

This paper introduces a method for improving the sensitivity to NO2 gas of a p-type metal oxide semiconductor gas sensor. The gas sensor was fabricated using CuO nanowires (NWs) grown through thermal oxidation and decorated with ZnO nanoparticles (NPs) using a sol-gel method. The CuO gas sensor with a ZnO heterojunction exhibited better sensitivity to NO2 gas than the pristine CuO gas sensor. The heterojunction in CuO/ZnO gas sensors caused a decrease in the width of the hole accumulation layer (HAL) and an increase in the initial resistance. The possibility to influence the width of the HAL helped improve the NO2 sensing characteristics of the gas sensor. The growth morphology, atomic composition, and crystal structure of the gas sensors were analyzed using field-emission scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy, and X-ray diffraction, respectively.

A k-space-to-image reconstruction network for MRI using recurrent neural network.

PURPOSE: Reconstructing the images from undersampled k-space data are an ill-posed inverse problem. As a solution to this problem, we propose a method to reconstruct magnetic resonance (MR) images directly from k-space data using a recurrent neural network. METHODS: A novel neural network architecture named "ETER-net" is developed as a unified solution to reconstruct MR images from undersampled k-space data, where two bi-RNNs and convolutional neural network (CNN) are utilized to perform domain transformation and de-aliasing. To demonstrate the practicality of the proposed method, we conducted model optimization, cross-validation, and network pruning using in-house data from a 3T MRI scanner and public dataset called "FastMRI." RESULTS: The experimental results showed that the proposed method could be utilized for accurate image reconstruction from undersampled k-space data. The size of the proposed model was optimized and cross-validation was performed to show the robustness of the proposed method. For in-house dataset (R = 4), the proposed method provided nMSE = 1.09% and SSIM = 0.938. For "FastMRI" dataset, the proposed method provided nMSE = 1.05 % and SSIM = 0.931 for R = 4, and nMSE = 3.12 % and SSIM = 0.884 for R = 8. The performance of the pruned model trained the loss function including with L2 regularization was consistent for a pruning ratio of up to 70%. CONCLUSIONS: The proposed method is an end-to-end MR image reconstruction method based on recurrent neural networks. It performs direct mapping of the input k-space data and the reconstructed images, operating as a unified solution that is applicable to various scanning trajectories.

Impact of right ventricular systolic pressure in elderly patients admitted to intensive care unit after femur fracture surgery: A retrospective observational study.

The number of femoral fractures is expected to continue to increase as the size of the older population rapidly grows. However, old age is accompanied by various comorbidities and is an important postoperative risk factor in itself, meaning that patients who undergo surgery for a femur fracture may require admission to an ICU. We investigated pulmonary complications in patients over the age of 65 admitted to the ICU after femur fracture surgery.In this single-center retrospective observational study, 289 patients over 65 years who admitted to the ICU after femur fracture surgery between June 2008 and December 2016 were investigated.Pulmonary complications occurred in 97 of these patients (33.6%) after surgery. Mean hospitalization days (34.1 ±â€Š25.7 vs 23.1 ±â€Š15.7, P < .001) and mean ICU length of stay (8.4 ±â€Š16.1 vs 2.5 ±â€Š1.1, P = .001) were significantly longer for patients with pulmonary complications than for patients without pulmonary complications after femur fracture surgery. Patients with pulmonary complications were significantly more likely to have pulmonary disease (19.6% vs 8.9%, P = .009) and exhibit sequelae on preoperative chest X-rays (9.3% vs 3.6%, P = .048) than were patients without pulmonary complications. In addition, significant differences were observed in the right ventricular systolic pressure (RVSP) measured during preoperative echocardiography (37.4 ±â€Š10.9 mm Hg vs 40.7 ±â€Š9.3 mm Hg for patients without and with pulmonary complications, P = .010) and in the proportion of each group that had an RVSP of >35 mm Hg, which is a marker for pulmonary hypertension (55.2% vs 76.3% for patients without and with pulmonary complications, P < .001). In multivariate analysis, an RVSP of >35 mm Hg during preoperative echocardiography was associated with pulmonary complications after femur fracture surgery (OR, 2.6; 95% CI, 1.45-4.53).In conclusion, Pulmonary complications in older patients admitted to the ICU after femur fracture surgery was associated with longer hospitalization and ICU stays. Preoperative RVSP measurement could identify those older patients with a high risk of pulmonary complications following transferal to the ICU after femur fracture surgery.

Diagnostic yield of additional conventional transbronchial lung biopsy following radial endobronchial ultrasound lung biopsy for peripheral pulmonary lesions.

BACKGROUND: Radial endobronchial ultrasound (R-EBUS) transbronchial lung biopsy (TBLB) improves the diagnostic yield from peripheral pulmonary lesions (PPLs). However, the small specimens obtained using small forceps through a guide sheath (GS) may impede diagnosis and molecular analysis. Here, we investigated the diagnostic significance of additional conventional TBLB with standard forceps after R-EBUS-GS-guided TBLB. METHODS: We retrospectively reviewed data from 55 patients who underwent conventional TBLB after R-EBUS-GS-guided TBLB for PPL diagnosis. Procedures were performed on single PPLs with no visible lesions on bronchoscopy. In cases with inconclusive pathologic confirmation, final diagnoses were made based on pathologic specimens or clinical observations. RESULTS: The median size of the target lesions was 28 mm. The appearances on computed tomography images were solid (n = 45, 81.8%), part-solid (n = 7, 12.7%), and cavitary nodules (n = 3, 5.5%). A computed tomography bronchus sign was present in 35 (63.6%) cases, and a radial probe was positioned within target lesion in 32 (58.2%) cases. R-EBUS-GS-guided TBLB was diagnostic in 30 (54.5%) patients, and subsequent conventional TBLB yielded additional diagnostic information in 8 (14.5%) patients. Probe positioning within target lesions and the outer margin of PPLs more than 1 cm from pleura were significantly associated with enhanced diagnostic yield from the combined procedures. In conventional TBLB, probe positioning within target lesions (75.0% vs. 11.8%, P = 0.004) and characteristic of nonsolid nodules (83.3% vs. 15.8%, P = 0.006) were significantly associated with additional diagnostic utility. CONCLUSIONS: Conventional TBLB following R-EBUS-GS-guided TBLB could be a useful procedure for diagnosing PPLs, especially for nonsolid nodules. KEY POINTS: Significant findings of the study: Additional conventional TBLB with standard forceps after R-EBUS-GS-guided TBLB yielded an additional 14.5% diagnostic utility for peripheral pulmonary lesions. For conventional TBLB, probe positioning within target lesions and nonsolid nodules were significantly associated with additional diagnostic utility. WHAT THIS STUDY ADDS: Conventional TBLB with standard forceps after R-EBUS-GS-guided TBLB is an effective and economically accessible diagnostic tool for peripheral pulmonary lesions.

Synthesis of Pd-Pt Ultrathin Assembled Nanosheets as Highly Efficient Electrocatalysts for Ethanol Oxidation.

Control over composition and morphology of nanocrystals (NCs) is significant to develop advanced catalysts applicable to polymer electrolyte membrane fuel cells and further overcome the performance limitations. Here, we present a facile synthesis of Pd-Pt alloy ultrathin assembled nanosheets (UANs) by regulating the growth behavior of Pd-Pt nanostructures. Iodide ions supplied from KI play as capping agents for the {111} plane to promote 2-dimensional (2D) growth of Pd and Pt, and the optimal concentrations of cetyltrimethylammonium chloride and ascorbic acid result in the generation of Pd-Pt alloy UANs in high yield. The prepared Pd-Pt alloy UANs exhibited the remarkable enhancement of the catalytic activity and stability toward ethanol oxidation reaction compared to irregular-shaped Pd-Pt alloy NCs, commercial Pd/C, and commercial Pt/C. Our results confirm that the Pd-Pt alloy composition and ultrathin 2D morphology offer high accessible active sites and favorable electronic structure for enhancing electrocatalytic activity.

Clinical features and outcomes in patients with pulmonary complications during pregnancy and peripartum.

Introduction: The aim of this study was to investigate clinical features and identify maternal factors contributing to prognosis in women with pulmonary complications during pregnancy and the peripartum period.Materials and methods: Following a retrospective review of clinical data and radiographic findings between January 2006 and January 2016, 126 women diagnosed with pulmonary complications during pregnancy (N = 79) and peripartum within the first 4 weeks after delivery (N = 47) were enrolled in this study.Results: Of the 126 patients, 113 (89.7%) required hospitalization. The median age was 32 years, and the percentage of primiparous women was 49.2%. The most common respiratory complaint was dyspnea, followed by cough and fever. Pneumonia developed in 50 patients (39.6%), pulmonary edema in 31 (24.6%), pleural effusion in 28 (22.2%), active pulmonary tuberculosis in 13 (10.3%), and asthma exacerbation in 4 (3.1%). Among the 79 antenatal patients with pulmonary complications, 31 (39.2%) experienced pregnancy-related complications, 21 (26.6%) had an emergency C-section, and 29 (36.7%) had an adverse fetal outcome. Eleven patients (8.7%) developed acute respiratory failure requiring mechanical ventilation, and the overall mortality was 1.6% (2/126) with no pulmonary complication-related deaths. Multiple regression analysis revealed that presence of pregnancy-related complications and younger fetal gestational age at the diagnosis were independent predictive factors for adverse fetal outcomes.Discussion: Pulmonary complications during pregnancy and the peripartum period resulted in poor outcomes, and the risk of adverse fetal outcomes was high, particularly in patients with pregnancy-related complications and younger gestational age at the diagnosis.